Yvonne LeBlanc, Manager of Pharmacy Operations for New England Quality Care Alliance (NEQCA), discusses the role of pharmacists in accountable care. This episode explores how clinical pharmacists are underutilized despite what we now know about their ability to help contain total cost of care for patients and ensure high quality of care – and how ACOs can better leverage pharmacy resources to impact their populations.
Fred Goldstein, President & Founder of Accountable Health, shares his thoughts about giving communities a mechanism to create interventions to improve their own health. In the value-based world, health care providers are trying to keep people healthy and are incentivized to do so, but what if we shift some of that responsibility and those incentive dollars to the communities themselves?
Clay Farris, Practice Lead of Mostly Medicaid, joins us to talk about the national Medicaid landscape. He discusses value-based care in Medicaid, how to succeed as a Medicaid ACO, and what to expect moving forward.
Learn about the role community based organizations play in serving patients with high needs and the imperative for these community partners and ACOs to partner to provide care coordination and care management for patients with severe mental illness. Our own, Lisette Roman sits down with Mary Takach from Boston Healthcare for the Homeless to learn about their efforts to care for the homeless population in a risk-based environment.
Dr. John Sargent, Chief of Child and Adolescent Psychiatry at Tufts Medical Center, discusses the importance of behavioral health care as an integrated component of primary care and his role as a pediatric psychiatry consultant to primary care physicians and care teams in a Medicaid Accountable Care Organization. We dive into how an ACO can ensure that patients are receiving the right level of behavioral health care at the right time.
Hear Dr. Corey Waller, a national addiction expert, discuss what the health care system can be doing better to treat substance use disorders, why ACOs should be focusing on addiction, and how addiction can be successfully treated as a chronic disease.
Interdisciplinary case management can not only lower total cost of care, but also improve patients' lives. Our own Sarah Matousek sits down with a case management team to learn about how the MassHealth Medicaid program is allowing them to use meaningful interventions.
Connecting with community organizations allows providers to better coordinate care, meet patient needs, and provide services in an accessible way. Sarah and Shelia discuss the importance of community connections for community health.
The financial incentives and alternative payment model details play a key role in determining the impact and success of Accountable Care Organizations. Sarah and Dr. Seeley discuss the current financial structures and what trends we are likely to see.
As an ER physician, Dr. Thea James has long been a leading voice advocating for hospitals to invest in addressing the root causes of health that drive people to show up in her ER. In this episode, we will hear about the powerful programs that Dr. James and Boston Medical Center have invested in to improve social determinants of health for patients they serve in Boston.
Comprehensively collecting and analyzing patient data can give providers a more complete picture of their patient’s health and better direct care and resources. In this episode, we hear how one innovative MassHealth ACO is using data and highlight best practices for all organizations transitioning to value-based care.
Doctors are increasingly being pulled in multiple directions based on whether they are still being paid a flat fee for every service they provide, given a lump sum per patient or procedure, or are being asked to focus on the health of an entire patient population. Dr. Namita Mohta and Sarah dive into how providers and healthcare organizations today can navigate these conflicting incentives.
Insurers and providers often see each other as adversaries, but ACO arrangements offer a unique opportunity to align interests and bring them onto the same team. Sarah sits down with Mike Nickey of Fallon Health to discuss how insurers and providers are being more collaborative than ever to implement value-based care.
Dr. John McDonough has been on the forefront of health reform for the better part of three decades – working intimately on the design and passage of both Massachusetts’ landmark 2006 healthcare law and later the Affordable Care Act. In this episode, John sits down with Sarah to discuss what value-based care means for the delivery of medicine, how we got here, and what makes MassHealth’s Medicaid ACO approach unique.